Increased health-related quality of life impairments of male and female survivors of childhood cancer: DCCSS LATER 2 psycho-oncology study

Marloes van Gorp, Loes M. E. van Erp, Anne Maas, Leontien C. M. Kremer, Eline van Dulmen-den Broeder, Wim J. E. Tissing, Jacqueline J. Loonen, Helena J. H. van der Pal, Andrica C. H. de Vries, Marry M. van den Heuvel-Eibrink, Cecile M. Ronckers, Dorine Bresters, Marloes Louwerens, Margriet van der van der Loo, Gea A. Huizinga, Heleen Maurice-Stam, Martha A. Grootenhuis*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: The objective of this study was to compare the health-related quality of life (HRQOL) of Dutch adult male and female childhood cancer survivors (CCSs) to general population references and to study medical determinants. Methods: CCSs from the Dutch Childhood Cancer Survivor Study LATER cohort (1963-2001) part 2, who were 18 years old or older (time since diagnosis ≥ 5 years), were invited to complete the TNO-AZL Questionnaire for Adult Health-Related Quality of Life. Domain scores and proportions of CCSs with impaired HRQOL (score < 25th percentile of the reference scores) were compared with references via Mann-Whitney U tests and logistic regression analyses corrected for age and sex (P <.004). Interactions of group with sex were included if they were significant (P <.05). Moreover, medical determinants were analyzed with multivariable logistic regression analyses. Results: HRQOL scores for 1766 CCSs (mean age, 35.9 years [standard deviation, 9.4 years]; male, 51%; response rate, 71%) differed from references on most domains with small effect sizes. Both male and female CCSs were more often impaired in gross and fine motor functioning, cognitive functioning, sleep, and vitality with odds ratios (ORs) > 1.4. In addition, female CCSs were more often impaired in daily activities, pain, and sexuality (ORs, 1.4-1.9) and were less often aggressive (OR, 0.6). CCCs of central nervous system (CNS) tumors, bone tumors, and retinoblastoma and those with cranial, abdominopelvic, or lower extremity radiotherapy were at increased risk of impairment in 1 or more domains. Conclusions: Dutch adult CCSs, especially females, have impaired HRQOL in several domains; this is most pronounced in cognitive functioning. The vulnerabilities of subgroups at risk, such as CCSs of CNS tumors, were confirmed. Surveillance of HRQOL and multidisciplinary survivor care are recommended. Lay Summary: The health-related quality of life in a Dutch nationwide cohort of 1766 survivors of childhood cancer was studied. Survivors of childhood cancer were found to have lower health-related quality of life in several domains (eg, motor functioning and vitality) in comparison with the general population. They most often reported low cognitive functioning (eg, memory and attention). Females had low health-related quality of life in more domains than males. Survivors of brain tumors had low health-related quality of life in most domains. Monitoring health-related quality of life regularly and collaborating between disciplines in survivor care is recommended.

Original languageEnglish
Pages (from-to)1074-1084
Number of pages11
Issue number5
Early online date2 Nov 2021
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
Funding for this study was provided by the KiKa Foundation.

Publisher Copyright:
© 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

Research programs

  • EMC MM-02-54-03


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